Was American Idol Judge Hooked on Fentanyl?

Carlsbad, CAIn a revealing interview in the June, 2009 issue of Ladies Home Journal, pop sensation and reality TV show star Paula Abdul recounts a life filled with chronic pain, complete with a 12-year addiction to painkillers that finally ended this past fall. What those painkillers were, she did not say. However Abdul did make reference to a pain patch that delivered pain medication claimed to be 80 times more potent than morphine. Fentanyl has been described elsewhere, in those terms.

"The Duragesic fentanyl patch is a powerful opioid narcotic designed for cancer patients and others who suffer from chronic, debilitating pain. And for these patients, the fentanyl patch has been a godsend.

However there have been various and ongoing issues with the product in recent years. A series of recalls over a potential manufacturing defect elicited concern over too much medication releasing from the self-contained medication reservoirs in the patch, defeating the integral time-release transdermal mechanism inherent with the patch design.

A secondary concern, but no less important, was the potential for secondary contact by caregivers, children and others not conditioned to the rigors of opioid medicine. While patients properly conditioned to narcotic medication fared well with a properly functioning patch, others who might have innocently come into contact with a fentanyl patch—such as a caregiver, or children—could face dire consequences.

That's because fentanyl, considering the chronic sector for which it was designed, is extremely powerful. It has been described in various sources, including a May 2006 report by the Associated Press, as "80 times more powerful than morphine."

Given Paula Abdul's alleged admission to the Ladies Home Journal that she was taking a painkiller, in patch form that she described in similar terms, it is not unreasonable to suspect Abdul might have been using the Duragesic fentanyl patch for her chronic pain.

Abdul had every reason to. As a youth she sustained a back injury. As an adult, and well into her career as a singer and much-respected dancer / choreographer, she broke her leg rehearsing a complex dance routine. After that came a serious car accident, followed by a plane crash that put her through more than a dozen spinal surgeries.

Such chronic pain would make Abdul a candidate for the Duragesic fentanyl patch, if indeed she wore the Duragesic. She admitted to using a patch with medication of equal potency to that which fentanyl is described. The singer and reality TV star also spoke of using various Chinese medicines to combat her chronic pain.

However, fentanyl is also highly addictive. There is growing speculation, therefore that the fentanyl patch may have been the basis for Abdul's behavior on past episodes of American Idol, on which she allegedly appeared at times disoriented.

That all seems to be behind the 47-year-old star now. Last Thanksgiving she checked herself into the La Costa Resort and Spa in Carlsbad, California to kick her addiction to painkillers—whatever they may be—and is now back on American Idol if not pain-free, at least medication free.

Given the horrendous events Abdul has been through in her life, one can only wish good things for the singer as she enjoys the dawning of her new day. That said, speculation continues as to just what it was, specifically, that she was addicted to. Was it the Duragesic fentanyl transdermal patch? And what does that possibility say about the potential for addiction, and other concerns inherent with a medication that has been described as 80 times more potent than morphine?

Many deaths have been reported amongst patients who have misused the fentanyl patch, or were not made aware just how potent the medication is. Some doctors have even prescribed the patch without determining the patient's tolerance for narcotics.

With the Duragesic fentanyl patch, caution is the watchword. For such a powerful drug, no other response will do.